环氧合酶-2表达与幽门螺杆菌相关性胃十二指肠疾病的研究

目的　探讨环氧合酶 2表达与幽门螺杆菌Helicobacterpylori ,H .pylori相关性胃十二指肠疾病的关系 ,并通过抗菌治疗评价根除H pylori感染对胃窦黏膜中COX 2表达的影响。方法　用免疫组化方法半定量检测 2 64例经胃镜和组织病理学检查患有十二指肠球部溃疡、胃溃疡、复合性溃疡、胃癌、单纯性慢性胃炎及胃黏膜正常者的胃窦黏膜COX 2蛋白的表达 ,比较H pylori感染与非感染者之间的差异。对检出的 3 5例H pylori的单纯慢性胃炎进行H pylori抗菌根除治疗 ,比较根除前后胃窦黏膜COX 2蛋白的表达变化。根据 2 0 0 0年 5月全国慢性胃炎研讨会共识意见 (江西 井冈山 )对胃黏膜炎症、活动性、异型增生、肠化生和H pylori密 ,度进行半定量测定。结果　胃黏膜表面上皮、腺上皮细胞和固有层间质细胞的浆中可见COX 2蛋白表达 ,但阳性染色细胞多集中在表层上皮。 2 53例中 ,14 3例H pylori者 (56 52 % )COX 2平均阳性细胞率显著高于 110例H pylori者 (43 48% ) ,(P =0 ) ,各疾病组H pylori患者的COX 2平均阳性细胞率均显著高于H pylori者 (P =0 ) ,各疾病组H pylori患者COX 2平均阳性细胞率也均显著高于正常对照组 (P <0 0 5)。 2 7例H pylori根除后的胃黏膜COX 2平均阳性细胞率明显下降 (P =0 ) ,但仍明显高于正

Research on Cyclooxygenase-2 expression in Helicobacter pylori associated gastroduodenal diseases

ObjectiveTo investigate the relation betwee n cyclooxye nase-2(COX-2) expression and Helicobacter pylori(H pylori)-associat ed gastroduodenal diseases,and to evaluate the effect of eradication of H pylori infection on COX-2 expr ession in the antral mucosa of patients before and after antibiotic therapy.MethodsTissues were obtained from 264 persons whose endoscopi c and pathologic diagnoses were duodenal bulbar ulcer,gastric ulcer,compound ul cer,gastric cancer,chronic gastritis and normal.35 patients with chronic gastrit is and H pylori infection and subsequent eradication were studied.COX-2 pr otein was st ained by immunohistochemical method.Gastritis,dysplasia,intestinal met aplasia(I M) and H pylori infection status were graded according to the updated Jingg angshan con sensus of opinion.ResultsIn antral mucosa of all sections,patc hy cytoplasmic staining of COX-2 protein could be detected on the surface and g landular epithelial cells,as well as lamina propria mesenchymal cells;but the vast majori ty of positively staining cells were seen on the surface epithelial region.The m ean percentage of the cells staining with COX-2 was significantly higher in 143 H pylori(+),in contrast with 110 H pylori(-)(P=0).The similar stat istical difference cou ld be seen between H pylori(+) and H pylori(-)(P=0),and also seen in 27 patients between before and after successful eradication of H pylori (P=0).However,comp ared with n ormal controls,the percentage of COX-2 expressing cells was significantly highe r not only in the group of after successful eradication of H pylori patients (P=0),b ut also in each group of H pylori(-) patients(P<0.05).At the same time ,compared w ith normal controls,COX-2 expressing levels had higher relation with the activi t y and degree of gastritis (P=0) In contrast with normal controls,in 75 pati ents with chronic active gastitis(CAG),and in 5 patients with dysplasia as well as in 13 patients with IM,COX-2 expression were significantly higher,and the dysplas i a group was the highest.COX-2 immunostaining closely correlated with the degree of H pylori(+)(rs=0.780,P=0) and the chronic inflammation score(rs=0.68 6,P=0). ConclusionsH pylori infection leads to gastric mucosal ov erexpression of COX-2 protein,and COX-2 immunostaining closely correlated with the degree of H p ylori(+) and the chronic inflammation score;Despite the reduction in COX-2 expressions a f ter H pylori eradication,expression of COX-2 remained higher than normal c ontrol group .In H pylori(-)CG and in IM as well as in dysplasia,COX-2 expressions were significant ly higher than normal group;suggesting that the COX-2 is involved in both non malignant and malignant gastroduodenal diseases.